Characterizing post-SSRI sexual dysfunction and its impact on quality of life through an international online survey

Abstract

BACKGROUND:

Post-SSRI sexual dysfunction (PSSD) is an underrecognized and poorly understood medical condition characterized by sexual dysfunction that persists despite SSRI discontinuation.

OBJECTIVE:

We conducted a survey of individuals with PSSD to better characterize this condition and its impact on various quality of life concerns.

METHODS:

Surveys were distributed to an online support group for individuals with PSSD. Surveys assessed medications suspected of causing PSSD and symptoms experienced during and after treatment. Respondents reported the trajectory of their condition, the efficacy of different treatments, and the impact of PSSD on their quality of life.

RESULTS:

239 survey responses were included in this study. A majority of respondents had a history of SSRI use (92%) compared to only SNRI or atypical antidepressant use (8%). The overall severity of symptoms improved for 45% and worsened or remained the same for 37% of respondents after discontinuing treatment with serotonin reuptake inhibitors. Only 12% of respondents reported being counseled regarding potential sexual dysfunction while taking antidepressants. The majority rated the effect of PSSD on their quality of life as extremely negative (59%) or very negative (23%).

CONCLUSION:

PSSD can have an overwhelmingly negative impact on quality of life. Currently, it is unclear why certain individuals develop PSSD and there are no definitive treatments for this condition. Further research of PSSD and greater awareness of this condition is needed among prescribers of serotonin reuptake inhibitors to improve patient care.

Keywords

Post-SSRI sexual dysfunction selective serotonin reuptake inhibitors sexual dysfunction adverse effects drug side effects

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References

Reisman

. Post-SSRI sexual dysfunction. BMJ. 2020;368.

Reisman

. Sexual consequences of post-SSRI syndrome. Sex Med Rev. 2017;5(4):429–33.

Ferguson

. SSRI antidepressant medications: Adverse effects and tolerability. Prim Care Companion J Clin Psychiatry. 2001;3(1):22.

Montejo

Prieto

de Alarcón

Casado-Espada

de la Iglesia

Montejo

. Management strategies for antidepressant-related sexual dysfunction: A clinical approach. J Clin Med. 2019;8(10):1640.

Csoka

Shipko

. Persistent sexual side effects after SSRI discontinuation. Psychother Psychosom. 2006;75(3):187.

Prozac (Fluoxetine Hydrochloride) Capsules Label [Internet]. FDA; Available from: www.accessdata.fda.gov/drugsatfda_docs/label/2011/018936s091lbl.pdf.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1980.

PRAC recommendations on signals [Internet]. 2019. Available from: https://www.ema.europa.eu/en/documents/prac-recommendation/prac-recommendations-signals-adopted-13-16-may-2019-prac-meeting_en.pdf.

Stahl

Pradko

Haight

Modell

Rockett

Learned-Coughlin

. A review of the neuropharmacology of bupropion, a dual norepinephrine and dopamine reuptake inhibitor. Prim Care Companion J Clin Psychiatry. 2004;6(4):159.

10.

Giatti

Diviccaro

Panzica

Melcangi

. Post-finasteride syndrome and post-SSRI sexual dysfunction: Two sides of the same coin? Endocrine. 2018;61(2):180–93.

11.

Healy

Le Noury

Mangin

. Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases. Int J Risk Safety Med. 2018;29(3–4):125–34.

12.

Bala

Nguyen

Hellstrom

. Post-SSRI sexual dysfunction: A literature review. Sex Med Rev. 2018;6(1):29–34.

13.

Coskuner

Culha

Ozkan

Kaleagasi

. Post-SSRI sexual dysfunction: Preclinical to clinical. Is it fact or fiction? Sex Med Rev. 2018;6(2):217–23.

14.

Hogan

Le Noury

Healy

Mangin

. One hundred and twenty cases of enduring sexual dysfunction following treatment. Int J Risk Safety Med. 2014;26(2):109–16.

15.

Reisman

. Are there any sex/gender differences in post-selective serotonin reuptake inhibitors (SSRI) sexual dysfunction (PSDD)? Curr Sex Health Rep. 2019;11(4):237–42.

16.

Ben-Sheetrit

Aizenberg

Csoka

Weizman

Hermesh

. Post-SSRI sexual dysfunction: Clinical characterization and preliminary assessment of contributory factors and dose-response relationship. J Clin Psychopharmacol. 2015;35(3):273–8.

17.

Pratt

Brody

, Antidepressant Use among Persons Aged 12 and Over: United States, 2011–2014. NCHS Data Brief. Number 283. National Center for Health Statistics. 2017.

18.

Healy

Le Noury

Mangin

. Post-SSRI sexual dysfunction: Patient experiences of engagement with healthcare professionals. Int J Risk Safety Med. 2019;30(3):167–78.

19.

Hunkeler

Ming

Lee

Fireman

Markson

. Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: Patient report versus physician estimate. J Clin Psychiatry. 2004;65:959–65.

20.

Olfson

Kroenke

Wang

Blanco

. Trends in office-based mental health care provided by psychiatrists and primary care physicians. J Clin Psychiatry. 2014;75(3).

21.

Young

Klap

Sherbourne

Wells

. The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry. 2001;58(1):55–61.

22.

Mark

Levit

Buck

. Datapoints: Psychotropic drug prescriptions by medical specialty. Psychiatr Serv. 2009;60(9):1167.